Arms Length Bodies (ALBs)

21st November 2006

What is an Arms length body (ALB)?

ALBs are stand alone national organisations sponsored by the Department of Health. They are a key part of the health and social care system and undertake a range of functions in line with national priorities. In particular they are regulate the health and social care system, establish national standards, protect patients and the public, and provide central services to the NHS. ALBs are accountable to the Department of Health.

What do they do?

There are 3 types of ALBs:

• Regulatory ALBs – hold the health and social care system to account.

• Public welfare and standards ALBs – focus safety and the protection of patients and the public.

• Commission for Social Care Inspection (CSCI) - the independent inspectorate for all social care services in England provides a comprehensive view of the quality and performance of social care services.

• Council for Healthcare Regulatory Excellence (CHRE) - oversees professional self-regulatory bodies and facilitates joint working across the UK.

• General Social Care Council (GSCC) - sets standards and regulates the social care workforce in England.

• Healthcare Commission - promotes improvement in the quality of NHS healthcare in England and Wales. Also regulates the independent healthcare sector in England.

• Human Fertilisation and Embryology Authority (HFEA) - licences and monitors in vitro fertilisation (IVF), donor insemination and human embryo research in clinics, and regulates the storage of sperm, eggs and embryos.

• Human Tissue Authority (HTA) - responsible for implementing the Human Tissue Act. It regulates activities such as anatomical and post-mortem examinations, transplantations and the storage of human material for education, training and research.

• Medicines and Healthcare products Regulatory Agency (MHRA) - ensures an acceptable standard of safety, quality and performance for UK medicines and devices sold or supplied for human use.

• Mental Health Act Commission (MHAC) - reviews the operation of the Mental Health Act 1983 in relation to patients detained under the Act and proposes amendments to the Secretary of State.

• Monitor - the independent regulator of NHS Foundation Trusts.

• Postgraduate Medical Education and Training Board (PMETB) - supervises postgraduate medical education and training in the UK. It is responsible for: establishing and raising standards and quality and providing arrangements to ensure this quality is maintained.

Public welfare and standards ALBs comprise:

• Commission for Patient and Public Involvement in Health (CPPIH) - ensures the public is involved in decision making about health and health services in England.

• National Biological Standards Board (NBSB)and National Institute for Biological Standards and Control (NIBSC) - plays a national and international role in the "standardisation and control" of biological substances used in medicine.

• National Institute for Health and Clinical Excellence - promotes clinical excellence and the effective use of resources within the NHS in England and Wales. It provides guidance for healthcare professionals, patients and their carers.

• National Treatment Agency for Substance Misuse (NTA) - works to improve the availability, capacity and effectiveness of treatment for drug misuse in England.

Central services ALBs comprise:

• Business Services Authority - the main payment and transactions processing facility for the payment, reimbursement and remuneration NHS patients, employees and affiliated parties. • Information Centre for Health and Social Care - coordinates and streamline the collection and sharing of data about health and adult social care.

• National Programme for Information Technology (NfIT) - develops, procures and implements modern, integrated IT infrastructures for all NHS organisations in England by 2010.

• NHS Appointments Commission (NHSAC) - appoints all chair and non-executive appointments to NHS trusts, PCTs and SHAs, and other bodies as delegated by the Secretary of State. It makes up to 1,500 appointments annually.

• NHS Blood and Transplant - promotes the donation of blood / organs, co-ordinates a 24-hour organ matching and allocation service, and manages the collection, preparation and distribution of blood.

• NHS Institute for Innovation and Improvement - works to integrate, promote and support innovation, learning, leadership and improvement in the NHS. Focuses on achieving practical outcomes that help the health service deliver better quality and more effective patient care.

• NHS Professionals (NHSP) - a not-for-profit service which provides medical and nursing staff to the NHS.

• NHS Purchasing and Supply Agency (NHSPASA) - acts as a centre of expertise, knowledge and excellence in purchasing and supply matters for the NHS in England.

Why were they reviewed?

In 2004 the Government undertook a review of the 38 ALBs with the aim of:

• Reducing bureaucracy in the health and social care system.

• Increasing efficiency in the public sector by achieving a 50% reduction in the number of ALBs, £0.5 billion expenditure savings and 25% reduction in posts.

• Devolving more powers to the frontline.

• Strengthening joint working between health and social care.

This led to the reduction and consolidation of ALBs as described below.

What is changing and when?

• In 2006:

o NHS Business Services Authority was established and took on all functions of the Dental Practice Board, NHS Counter Fraud and Security Management Service, NHS Pensions Agency, NHS Logistics Authority and Prescriptions Pricing Authority. These organisations were then dissolved.

• In 2007:

o Commission for Patient and Public Involvement to be dissolved. Functions to be retained by the patient forums.

• In 2008:

o New Healthcare Commission to be formed through merger with the Mental Health Act Commissioners and the Commission for Social Care Inspection.

o Health Protection Agency will take on responsibilities of National Radiological Board, National Biological Standards Board and National Institute for Biological Standards and Control.

o Creation of the Regulatory Authority for Tissue and Embryos, incorporating the Human Fertilisation and Embryology Authority and Human Tissue Authority.